There is no food that can cause lupus. Lupus is an autoimmune disease, an illness that can affect many body systems. The foods that you eat, however, and the medications you take may have an effect on some of your symptoms. It is also important to understand that there is a link between lupus and osteoporosis and cardiovascular disease. Healthy nutrition can greatly affect those with these co-occurring diseases. Nutrition may impact the symptoms and outcomes of these co-occurring illnesses.
A well-balanced diet with proper nutrition can positively benefit those living with lupus in the following ways:
There are some important general nutrition guidelines for individuals with lupus. Some key guidelines include diets low in fat, cholesterol, and sodium; low in refined sugars like soda and concentrated juices; and high in fiber. It is important to be aware of high protein diets which can often stress the kidneys. Most importantly, it is imperative to keep a well-balanced diet.
There are some key foods that are important for your diet. Having a balance is essential – that is, to not eat too much of one thing and not enough of another. Different foods have different nutritional components. Try to include a variety of fruits and vegetables; foods low in calories and saturated fats; and foods high in antioxidants, fiber, calcium, vitamin D, and Omega 3 fatty acids.
Fruits and vegetables contain antioxidants and fiber. They are a great source of Vitamin A and Vitamin C. Some healthy ways to add fruits and vegetables into your diet:
Not all fats are unhealthy. Polyunsaturated fats and monounsaturated fats are the healthier fats compared to saturated fats. Some of these fats are high in anti-inflammatory properties and have a rich source of Vitamin E. Foods that contain unsaturated fats include; nuts, seeds, avocados, olive oil, soybean oil, canola oil, avocado oil, peanut oil and vegetable oil. It is important to understand that these fats are still high in calories - therefore, portions should be monitored. These fats, however, are preferred over saturated fats.
Saturated fats, on the other hand, can increase inflammation. Some examples of saturated fats are high fat dairy foods (whole milk, half and half, cheeses, butter, and ice cream), fried foods, commercial baked goods, creamed vegetables/soups/sauces, sausages, Italian meats, red meat, animal fat, and processed meat products.
Avoid drenching your food in dressing, oil, butter, and sugar, which can increase your calorie intake. High calorie foods can cause weight gain and inflammation so it is important to make healthy choices when choosing what foods to eat.
It remains unproven whether diets high in antioxidants can help with inflammation associated with lupus. Fruits and vegetables are sources of antioxidants such as Vitamin A, Vitamin C, Vitamin E, Selenium, Carotenes, and Bioflavonoids.
Foods high in calcium and vitamin D promote healthy bones. Some medications for lupus deplete your body of calcium, so including calcium in your diet is essential. It can be found in foods like wild salmon (with bones), enriched/fortified soy milk, mushrooms (shitake), broccoli, kale, sardines (with bones), fortified milk, and fortified breakfast cereals. The recommendation for calcium intake is slightly different for men and women. For women less than 50 years of age, the recommendation is 1000 mg. For women over 50 years of age, the recommendation is 1200 mg. For men ages 50 to 70, the recommendation is 1000 mg and for those older than 70 years of age, it is 1200 mg. Vitamin D recommendation is the same for both men and women. For people less than 70 years of age, the recommendation is 600 IU a day and for those over 70 years of age, the recommendation is 800 IU a day.
Grains are a good source of fiber and energy, foliate, B6, B2, selenium, and zinc, and are naturally low in fat. Some whole grain foods include brown and wild rice, whole wheat bread, whole wheat pasta, rye, oats, quinoa, corn, and barley.
Dairy products hold the richest source of calcium and provide a good amount of protein, vitamin D, selenium, B vitamins, and zinc. Foods high in calcium are shown to help build strong teeth and bones, which are very important for lupus patients because of their high risk of osteoporosis.
When choosing dairy products, remember to go either low-fat or fat-free. Some examples include 1% and skim milk, low fat and low sodium yogurt, and low fat cheese. Foods to avoid are 2% and whole milk, which contain a large amount of fat and cholesterol. If you do not or cannot consume milk, choose lactose-free milk, soy milk, and almond milk that are fortified with calcium and Vitamin D. Aim for three or more servings a day.
They contain zinc and B vitamins and are a good source of Omega-3 fatty acids and protein to maintain muscle. Here are some healthy tips when buying and preparing your meats, fish, and poultry:
Research indicates that omega 3 fatty acids from fish or fish oils may help manage high triglycerides and heart disease (see references at end of this summary). A clinical trial is currently underway, led by investigators at HSS, to find out if supplementation with omega-3s can replenish the deficiency associated with lupus and/or slow down the progression of the disease or prevent flares. Foods rich in omega 3 fatty acids include salmon, sardines, mackerel, bluefish, herring, mullet, tuna, halibut, lake trout, rainbow trout, ground flaxseed, chia seeds, walnuts, pecans, canola oil, walnut oil, and flaxseed oil, and are part of a heart-healthy meal plan.
Good source of vitamin E, selenium, protein, and fiber. Some foods that you can snack on throughout the day include:
When purchasing, look for beans that are unsalted and low in sodium. When buying canned beans, make sure to rinse and drain excess liquid to remove extra sodium.
It is important to understand that osteoporosis has no symptoms. There is no pain in the bones where individuals with osteoporosis would hypothetically feel sore, so it is important to speak with your doctor to have a regular bone mass density test performed. Again, there is a high risk of osteoporosis for people with lupus because of often decreased physical activity, vitamin D deficiency, medication side effects, and the additional risk of kidney disease. Listed below are nutritional tips to follow:
It is important to not just rely on supplements to help improve your symptoms, as both diet and supplements together are important. You may need to take up to several doses per day of supplements to get the same effect that is in the food. Always try and consume the food before looking into supplements. When choosing supplements and vitamins, be sure to read the product labels carefully to make sure the ingredient lists make sense to you. Often some may have blood thinning effects. Speak with your doctor and keep in mind:
More studies need to be done to confirm the safety and effectiveness of supplements, so again, always consult with your doctor.
Some studies indicate that flaxseeds may protect against lupus nephritis (kidney disease associated with lupus). These studies are small and poorly controlled, therefore more research needs to be done to determine whether taking flaxseed supplements is helpful.
Some studies indicate that DHEA may have a role in reducing flares and disease activity; also a role in decreasing the need for steroids. These studies, however, are small and poorly controlled, therefore further studies are needed to determine the safety and effectiveness of DHEA.
Learn more about the HSS SLE Workshop, a free support and education group held monthly for people with lupus and their families and friends.
For more in-depth information, read Nutrition for Lupus-related Conditions: Heart and Kidney Disease
Summary Written by Christie Carlstrom, SLE Workshop Coordinator and Social Work Intern at HSS.
Sotiria Everett, MS, RD, CDN, CSSD
Hospital for Special Surgery
Sue Xiao Yu, MS, RD, CDN, CDE
Clinical Nutritionist Department of Food and Nutrition Services
Hospital for Special Surgery